Director: VA makes major strides in 2018

The Veterans Association hospital in Roseburg and the clinic in Brookings have come a long way since last year when both were facing numerous infrastructure and patient-care challenges, Interim Director Dave Whitmer told about 25 veterans at a quarterly meeting Tuesday night.

Numerous personnel have been hired, including an acting chief of staff and mental health providers in the behavioral rehabilitation center in Eugene. A new executive assistant to the director is on board, he said, and a director to replace Whitmer — a primary reason he was transferred from Florida to Oregon this year — is going through the final paperwork before he begins in February.

“I can’t tell you who that is; it’s controlled out of Washington, D.C.,” Whitmer said of the new director’s identity. “But he was hired two months ago and we’re waiting to clear the paperwork.”

The new director hails from the Pacific Northwest, is familiar with Roseburg and indicated the campus was his first choice.

“Then it’s my turn to go back home — I’ve been 3,000 miles away from home,” Whitmer said. “I’d never been to Oregon; I didn’t even know I was going to Oregon until eight days before I got here. I’ve thoroughly enjoyed my time.”

In 12 months ...

Staffing, a major challenge in rural areas the VA serves, was ramped up in the past year, Whitmer said.

Established patients in Brookings now only wait two days to meet with a healthcare provider; new patients wait an average of six. In Roseburg, that number has decreased to six days for an established patient and 21 for a new patient.

Mental health waits for established patients in Brookings is three days, but 22 for new patients, a period Whitmer said is unacceptable, but an issue the VA is addressing with more hiring.

The agency has established a “cultural transformation” that encourages employees to offer advice and make improvements without being chastised, and that has paid off in employee satisfaction, Whitmer said.

An employee survey showed a 6-point increase in the opinion that the VA in Roseburg is a “best place to work.”

“It’s not where we want to end up,” Whitmer said of the score of 60, “but the fact we did improve is a good thing. It does represent progress.”

He attributes it to the administration addressing concerns of communication, accountability and heavy workloads.

The clinic in Brookings — mere mention of its services and staff garnered a round of applause from veterans — has twice the space of the old facility on Fifth Street. It features four new tele-health service and eight exam rooms — compared to three in the old building — and rooms for women’s health exams and group therapy.

Its use — a goal of the VA to reduce the drive time from Curry County to Roseburg — is up in all categories except primary care since 2016, Whitmer said. The use of telehealth, on the low end, is up 22 percent — and social work services is up 544 percent.

There are two full-time providers, three nurses and a nurse manager, three vocational nurses, a health coach, a health technician, three medical support assistants and a housing support system consultant.

Community Care

The VA is also transitioning away from using Tri-West as a consultant and improving the process by which veterans can obtain healthcare procedures locally in the private healthcare realm — and coordinates veterans’ health records with those of that out-of-system doctor.

“As the Mission Act rolls out, there will be many more types of procedures you would have had to go to Roseburg for that you can do here,” Whitmer said. “When the VA had its episodes in Phoenix (Arizona) and Congress threw a bunch of money at it and said, ‘Go fix it,’ they learned that contracting out to a third party that isn’t aligned with our mission (isn’t ideal). Now, it will be VA employees, and if they don’t meet standards, I can find others that do. I’m excited about the changes for the system, but particularly for Brookings.”

Whole Health

The VA is just now beginning to realize the benefits of holistic health and has hired Penny Banks as a “whole health coach.”

Rather than merely treating a problem, the concept brings together all aspects of a veteran’s life — connections with others, exercise, nutrition, mindfulness and other social determinants — to help a patient achieve their health goals in life.

“I’m so passionate about healing and wellness,” Banks said. “I’m glad the VA is taking this path. It’s a huge one. To be a part of patients’ healing is such a great thing.”

The paradigm shift involves going from the perspective of “What’s the matter with you?” to “What matters to you?” she said, adding that 75 percent of disease is lifestyle related.

Programs now available in Brookings include standard and battlefield acupuncture — using acupuncture needles only in a patient’s ear — weight loss, smoking cessation, nutrition, chiropractic care, fitness and physical therapy, yoga and qigong, a Chinese relaxation method related to tai chi.

“The secret to change is to focus all of your energy, not on fighting the old, but building the new,” she said, quoting Socrates. “Let’s not stay stuck in the old. It’s real and it works.”

“This is much more proactive,” Whitmer said. “It’s very empowering. All of a sudden, you’re not on that long-term care. Your quality of life is better. It’s a big part of how the VA is going to deliver healthcare in the future.”

Other news

The VA clinic in North Bend is not closing, Whitmer announced to dispel rumors. The lease expired and the landlord has agreed to help with a needed expansion there.

They’re not seeing new patients, he said, because of difficulty in finding qualified staff. The VA ultimately wants a physician, nurse and two primary-care tele-health professionals staffed in the Coos County clinic.

The Oregon State Home for Veterans project is progressing as well, with 15 acres in Roseburg dedicated to the state and the VA paying 65 percent toward the $37 million cost, with the state picking up much of the rest of the tab.

State Veterans Homes are facilities that provide nursing home, domiciliary or adult day care. They are owned, operated and managed by state governments. They date back to the post-Civil War era to provide shelter to homeless and disabled veterans.

“The challenge will be how to staff it,” Whitmer said of state employees who will be needed. “There are a limited number of professionals, doctors, RNs.”

To that end, the VA is in discussions with a state university — he declined to name it — to create an Allied Health College to recruit and train people for jobs in radiology, nursing and physical therapy, among others.